文章：

免疫疗法在多发性骨髓瘤治疗中的应用

Immune-based therapies in the management of multiple myeloma

原文发布日期：2020-08-22

DOI: 10.1038/s41408-020-00350-x

类型: Review Article

开放获取: 是

英文摘要：

Multiple myeloma (MM) is a clonal plasma cell malignancy affecting a predominantly elderly population. The continued development of newer therapies with novel mechanisms of action has reshaped the treatment paradigm of this disorder in the last two decades, leading to a significantly improved prognosis. This has in turn resulted in an increasing number of patients in need of therapy for relapsed/refractory disease. Immune-based therapies, including monoclonal antibodies, immune checkpoint inhibitors, and most promisingly, adoptive cellular therapies represent important therapeutic strategies in these patients due to their non-cross resistant mechanisms of actions with the usual frontline therapies comprising of immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs). The anti-CD38 antibodies daratumumab and more recently isatuximab, with their excellent efficacy and safety profile along with its synergy in combination with IMiDs and PIs, are being increasingly incorporated in the frontline setting. Chimeric antigen receptor–T cell (CART) therapies and bi-specific T-cell engager (BiTE) represent exciting new options that have demonstrated efficacy in heavily pretreated and refractory MM. In this review, we discuss the rationale for use of immune-based therapies in MM and summarize the currently available literature for common antibodies and CAR-T therapies that are utilized in MM.
 

摘要翻译： 

多发性骨髓瘤（MM）是一种克隆性浆细胞恶性肿瘤，主要影响老年人群。近二十年来，具有新型作用机制的疗法持续发展，重塑了该疾病的治疗模式，显著改善了预后。这反过来导致需要治疗复发/难治性疾病的患者日益增多。基于免疫的疗法——包括单克隆抗体、免疫检查点抑制剂以及最具前景的过继性细胞疗法——因其与常规一线治疗（如免疫调节药物和蛋白酶体抑制剂）具有非交叉耐药的作用机制，成为这类患者的重要治疗策略。抗CD38抗体达雷妥尤单抗及近期应用的伊沙妥昔单抗，凭借其优异的疗效和安全性，以及与免疫调节药物、蛋白酶体抑制剂的协同作用，正日益被纳入一线治疗。嵌合抗原受体T细胞疗法和双特异性T细胞衔接器为代表的新兴疗法，已在经过深度治疗和难治性多发性骨髓瘤中展现出显著疗效。本综述将探讨多发性骨髓瘤中应用免疫疗法的理论基础，并汇总目前常用于多发性骨髓瘤的抗体及CAR-T疗法的相关文献。

原文链接：

Immune-based therapies in the management of multiple myeloma